[SUPERSELECTIVE PROSTATIC ARTERY EMBOLIZATION AS A PREPARATORY STEP BEFORE TURP IN THE TREATMENT OF BENIGN PROSTATIC HYPERPLASIA IN PATIENTS WITH LARGE PROSTATES]

Abstract

The study included 59 patients with benign prostatic hyperplasia (BPH) and high risk of anesthesia who underwent superselective embolization of prostatic arteries. The examination included a survey on the International Prostate Symptom Score (IPSS), assessment of quality of life (QoL), estimation of prostate and node size with transrectal ultrasound, determination of prostate-specific antigen level; in doubtful cases a needle prostate biopsy was performed. To analyze the quality of urination uroflowmetry was conducted. The effectiveness of the treatment was evaluated after 6, 12 and 24 months follow-up. By the 6th month of observation I-PSS score significantly decreased, while the maximum urine flow rate increased. This trend kept up during the subsequent six-month follow-up. The results of 24 months follow-up after embolization showed stable effect. Prostate and node volumes and reduced on average by 53% and 47%, respectively; the maximal reduction of prostate volume was 82%. 17 (28.8%) patients with prostate size reduction to less than 80 cm3 underwent transurethral resection of the prostate. In conclusion, prostatic artery embolization may be considered as a method of preoperative treatment of BPH patients with large prostates and multiple comorbidities, providing them with the possibility of endoscopic treatment. Further study will allow working out the methodology of embolization, to accurately determine the indications and contraindications for this treatment modality and to introduce it to clinical practice.